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OCA proposes aligned quality and equity measure set; plans to collaborate on hospital safety measures
Summary
OCA proposed adopting existing, publicly available measure sets for payers, physician organizations and hospitals, and said it will work with sibling state agencies to consider adding hospital patient‑safety (HAI) measures and to improve demographic stratification over time.
OCA presented a recommended quality and equity measure set that relies on existing public measure sets and committed to a coordinated process to add hospital patient safety measures after further interagency work.
Staff said OCA will adopt (or adopt a subset of) three existing measure sets to reduce reporting burden and align state reporting. For payers, OCA proposed using the Department of Managed Health Care’s Health Equity and Quality Measure Set (including its stratification rules). For physician organizations, OCA proposed a subset of the Office of the Patient Advocate (OPA) healthcare quality report card measures. For hospitals, OCA proposed using the full HCAI hospital equity measures reporting program and its stratification requirements. Staff noted that measures and stratification will evolve; OCA plans annual review and updates.
Several advisory members and public commenters urged OCA to add hospital patient‑safety measures, including healthcare‑associated infection (HAI) metrics. Staff described existing HAI reporting by the California Department of Public Health (CDPH) and said CDPH does not currently stratify HAIs by demographic characteristics. To address the concern, OCA plans to collaborate with Covered California, CalPERS and other agencies to develop an aligned set of hospital patient‑safety measures and to consider adding them to OCA’s measure set in fall 2025. OCA also said it will work with sibling agencies and measure‑set owners on improved demographic data collection (race/ethnicity, language, disability, sexual orientation and gender identity) and with research partners to explore extended equity analysis beyond simple stratification.
Public commenters and committee members supported alignment but raised caveats: some urged more behavioral‑health measures and broader stratification; others worried about small sample sizes for CAHPS surveys and the administrative burden of new measures. Several stakeholder commenters emphasized the value of outcome measures and the need for improved race/ethnicity data collection; one commenter noted Covered California has reached roughly 80 percent self‑reported race/ethnicity capture.
Staff said OCA will begin public reporting on the measure set in its June 2027 annual report and will coordinate measure changes with measure owners and regulated entities in advance of reporting.
